Meeting of the Parliament (Hybrid)
Meeting date: Wednesday, March 30, 2022
Agenda: Covid-19 Update, Portfolio Question Time, Maternity Services (Moray), Keeping the Promise Implementation Plan, Business Motions, Decision Time, Ovarian Cancer Awareness Month
- Covid-19 Update
- Portfolio Question Time
- Maternity Services (Moray)
- Keeping the Promise Implementation Plan
- Business Motions
- Decision Time
- Ovarian Cancer Awareness Month
Good afternoon. I remind members of the Covid-related measures that are in place. Face coverings should be worn when moving around the chamber and across the Holyrood campus.
The first item of business is a statement by Nicola Sturgeon on a Covid-19 update. The First Minister will take questions at the end of her statement, so there should be no interventions or interruptions.
I will set out the Cabinet’s decision on the timescale for converting the legal requirement to wear face coverings in certain indoor settings into guidance.
First, though, to set the context for that decision, I will give a brief update on the current Covid situation. The most recent Office for National Statistics Coronavirus infection survey, which is for the week ending 20 March, indicated that one in 11 people in Scotland had Covid. That is the highest level of infection so far recorded by the weekly survey, which reflects the impact of the highly infectious BA.2 subvariant of the virus. The daily case numbers also show a very high, though perhaps stabilising, level of infection.
Today, 9,610 new cases identified through polymerase chain reaction tests or lateral flow tests will be reported. Again, it is important to set those figures in context. Two weeks ago, on average, just over 12,400 new cases were being reported each day. One week ago, the average case number was still high, at around 12,000 a day. However, over the past week, that has fallen to 10,200 a day, which is a 15 per cent reduction in the past seven days. The reduction is fairly consistent across all age groups. That gives us grounds for optimism that the latest wave of infection may now have peaked.
Of course, the daily numbers on their own need to be treated with a degree of caution. However, the result of waste-water sampling, which is an important strand of our on-going surveillance, also gives some cause for optimism. The sampling does not yet indicate a fall in the level of infection, but it suggests that the situation has stabilised since mid-March.
We will therefore continue to assess the data closely, including, of course, the results of the latest ONS survey, which are due later this week. We are hopeful that the current wave has peaked or is now peaking. Indeed, that is being observed already in Northern Ireland, which, unlike England and Wales, appears to have been ahead of Scotland in the transmission of BA.2.
Although the BA.2 variant is highly infectious—indeed, it is more infectious than the original Omicron variant—it is important to stress that vaccination continues to provide strong protection against serious illness, which underlines the importance of getting all doses of vaccine that we are offered.
The programme of additional boosters for certain groups started three weeks ago in older people’s care homes and, as of last week, appointments are being offered to everyone aged 75 and over.
People with suppressed immune systems will have appointments for additional boosters scheduled during spring and summer, starting from 18 April. Appointment letters will be issued by post. Anyone who is unsure about eligibility for an additional booster should, of course, contact their doctor for advice.
In addition, the vaccination programme for five to 11-year-olds is under way. Children in that age group with specific medical conditions and those who are household contacts of someone who is immunosuppressed were already being vaccinated in line with Joint Committee on Vaccination and Immunisation advice.
Vaccination of the wider five to 11-year-old age group started on 19 March and will continue over the coming weeks. Older children are being given appointments first, but families are being invited to get vaccinated together whenever that is possible.
Obviously, with case rates being so high recently, some young people who are invited for a vaccine will recently have had Covid, so I will briefly summarise the guidelines for those circumstances.
Those aged five to 17 with specific medical conditions or who are household contacts of someone who is immunosuppressed should wait four weeks after first testing positive, or from the onset of symptoms, before being vaccinated. Four weeks is also the recommended gap for adults who get the virus. All others aged five to 17 should wait 12 weeks after having the virus before being vaccinated.
Parents or carers of children who have been unable to be vaccinated due to having Covid should call the helpline, on 0800 030 8013, to reschedule appointments if that is necessary. The advice to everyone remains as important as ever: please take the opportunity to get vaccinated as soon as you are able and make sure that you get all doses of the vaccine for which you are eligible. That remains the most important thing that any of us can do to protect ourselves and others, and it is never too late to get vaccinated.
Despite the effectiveness of vaccination, the high level of infection has put the national health service under even more severe strain in recent weeks. We are seeing the impact of that in all parts of the NHS, not least in our accident and emergency services. The number of people in hospital with Covid reported today, at 2,344, is, I am pleased to say, 39 fewer than yesterday, but yesterday’s figure was the highest that it had been since the start of the pandemic. Therefore, today’s number is still exceptionally high and it is significantly above the previous peak in hospital cases, which was 2,053, back in January 2021.
More positively—again, this is evidence of the power of vaccination—the number of patients in intensive care with Covid remains relatively low, at 26 on today’s figures, which is a fall of 15 in the past two weeks. Nevertheless, the volume of people in hospital with Covid is causing very significant pressure for a health service that has been dealing with the pandemic for more than two years now.
That means that we cannot and should not be complacent. For the period up until Easter, therefore, we are continuing to ask everyone to take a lateral flow test twice a week, to take a test daily for seven days if you are a close contact of someone who has tested positive, and to take a test before visiting someone who is vulnerable. If you have symptoms, you should continue to get a PCR test, either at a testing site or by post. If you test positive, you should isolate and follow the advice from test and protect.
Using the approach that we set out a few weeks ago in the revised strategic framework, and based on the Government’s clinical advice, our assessment is that the virus at this stage continues to present a medium threat. However, we remain optimistic that it will move to being a low threat during the course of the spring. We have already largely moved away from reliance on legally imposed protective measures, and we are now relying instead on vaccines, treatments and sensible public health behaviours and adaptations.
Indeed, nine days ago, we lifted all bar one of the remaining Covid legal requirements. However, at that point, we retained in law the requirement to wear face coverings on public transport and in certain indoor settings. I said two weeks ago that we would review that requirement before the Easter recess, which we have now done. We have taken account of the very high level of infection and the pressure on the NHS, and of the fact that face coverings provide an important layer of protection against transmission of the virus from one person to another. However, we are also mindful that the data may now be indicating a peaking of the current wave of infection, which should, we hope, become more pronounced over the next couple of weeks.
We have therefore concluded that, subject, as always, to the state of the pandemic, the legal requirement to wear face coverings will be replaced with guidance on the following phased basis. From next Monday, 4 April, it will no longer be a legal requirement to wear a face covering in places of worship or while attending a marriage ceremony, civil partnership registration or funeral service or commemorative event. Then the wider legal requirement that applies to shops, certain other indoor settings and public transport will be converted to guidance two weeks later, on 18 April. We will of course continue to encourage the wearing of face coverings in certain indoor places, especially where significant numbers of people are present.
That phased approach strikes a sensible balance between our desire to remove the one remaining legal measure and the commonsense need for continued caution, not least for the sake of the NHS, while the current wave of infection subsides. I recognise that face coverings are an inconvenience. However, given all the sacrifice of the past two years, and in view of the current pressure on the NHS, I believe that the vast majority of people will accept that, for a further two weeks, it is a proportionate precautionary measure while we pass the peak of the latest wave. It also provides some additional protection to those who are most at risk from the virus.
In conclusion, I want to take this opportunity to thank the public again for the patience and responsibility that continue to be demonstrated by the overwhelming majority of people across the country. Life has returned to normal for most of us, but Covid has not gone away. Indeed, in recent weeks, very few of us will have been untouched by the virus—either ourselves or within our families or networks of colleagues. That in itself is a sign of how infectious the virus continues to be, so while the level of infection remains as high as it is, I ask that people, please, continue to take sensible basic steps to protect themselves and others.
The First Minister will now take questions on the issues that were raised in her statement. I intend to allow about 20 minutes for questions, after which we will move on to the next item of business.
This week, the number of people in Scotland waiting four hours at accident and emergency departments reached the worst level since records began. More people are waiting longer for cancer treatment than at any point since 2008. People with critical conditions and others with potentially terminal illnesses are not getting the treatment that they need and deserve quickly enough.
The pandemic has made things worse, but the First Minister cannot get away with just blaming Covid, so will she set out the specific actions that her Government will take now to address those failings and to ensure that people in Scotland get the treatment that they need where they need it?
Turning to Covid, I note that case rates here are now far higher than they are anywhere else in the United Kingdom. The First Minister’s strategy is clearly failing, and because of her failing strategy, she is keeping restrictions in place here in Scotland weeks after they have been removed elsewhere. Countries across the UK and Europe have already removed restrictions and are living with Covid.
Today, the First Minister has signalled that face masks will continue to be required for several more weeks. We believe that anyone who wants to keep wearing a face mask should keep on doing so, particularly if it will help vulnerable friends and relatives, but it should be down to individuals’ choice, as it is in other parts of the United Kingdom. We should leave it up to people and businesses to decide what is best for them, based on public health advice. Nicola Sturgeon has to start trusting the people of Scotland.
Face masks are not just an inconvenience; they are really holding some people back. Retaining the requirement for face masks in schools and businesses is damaging young people’s education and limiting Scotland’s economy. The First Minister’s statement did not mention schools. When the requirement for face masks is lifted on 18 April, will that include removing them entirely from schools, and not just from classrooms?
We have now heard the third date when face masks will no longer be mandated in law. The First Minister previously said that the legal restriction would be lifted on 21 March, then she said that it would be lifted in early April, and now she says that it will be lifted on 18 April, so will the First Minister guarantee that there will be no further delays?
It has always seemed to me to be completely inconsistent to, on one hand, rightly and understandably express concerns about the pressure on our national health service and high levels of infections, while, on the other hand, bemoaning the very limited protective measures that are still in place to help to guide us through the pandemic.
There is very significant pressure on all parts of the national health service, but especially on our accident and emergency departments. In recent weeks, we have set out the range of steps that we are taking, backed by significant investment, to support the national health service through the pandemic and into recovery. That is about investment and continuing to increase the number of staff who work in our national health service, but it is also about reforming how care is delivered, so that people get timely access to care in the places where they need it.
The most immediate and important thing that we need to do to relieve pressure on our national health service is get the number of Covid cases down. We think that that is now happening, which is why I have given the statement that I have given today.
It is not the case that legal measures are not in place in any other part of the UK. Just yesterday, I spoke to the First Minister of Wales, which has different legal protections in place from the ones that we have, but still has some legal protections in place.
It is important that we take a cautious approach. All the evidence that I have seen on public opinion on the matter suggests that Douglas Ross is seriously out of step with the vast majority of people. People understand that if we all wear face coverings right now, particularly in public places where people do not always have a choice about whether to be there—people must go to shops, for example—we help to protect one another. For a couple of weeks more, while we see the wave of infection peak and start to fall, that is a sensible thing to do and I think that the vast majority of people agree. Although nobody wants to do it for longer than is necessary, I think that most people accept that it is a sensible precautionary measure.
Lastly, we expect the remaining requirement in schools to be lifted in line with the requirement for the general population.
I thank the First Minister for the advance copy of her statement.
The levels of Covid remain concerning, not least due to the impact on the NHS. Although life is returning to near normality for many people, that is not the case for those who are immunocompromised and for the 180,000 people who were on the shielding list. Where is the detail about testing for them and their family carers beyond April, and what about access to antivirals? When will the First Minister set out plans to ensure that those people and their carers are afforded assurance about what will happen to them?
While we are on the subject of testing, will testing in schools end? I understand that the advice that is being considered will be that pupils should stay off school if they have any symptoms, without knowing whether they have a cold or Covid. Pupils and staff absences are already high, which will cause disruptions to pupils’ education at the time when exams start. Given that very little has been done to improve ventilation in classrooms, will the First Minister reconsider the matter and ensure that asymptomatic testing continues in schools for at least the next two months?
Finally, I welcome the next stage of the vaccination programme, but we really should have learned the lessons from before and not be sending my 80-year-old constituent from Helensburgh to Dunoon—a 100-mile round trip on two ferries—to get their booster. Hundreds of people have been sent letters giving them appointments many miles away from their homes, and have been told that even if they were to get an appointment locally, they might need to wait until the end of May or the beginning of June. That is a problem with the national vaccination scheduling service. Can the First Minister ensure that it is fixed?
On vaccination in Argyll and Bute, we and those in Argyll and Bute have apologised to the people who have been affected by what was an error. My officials met the Argyll and Bute health and social care partnership and NHS Highland to ensure that the problem was being rectified as soon as it had been identified. Everyone who was affected will be contacted as soon as possible, with a new appointment for the correct local vaccination clinic to follow.
Obviously, in a large-scale programme, errors such as that are deeply regrettable when they happen, but that does not take away from the massive success of the vaccination programme, which is the only thing that is preventing all of us right now from having to live with much greater restrictions, because it is helping protect against serious illness.
On the wider questions about people with compromised or suppressed immune systems, they are, of course, being offered additional boosters. That is the first line of protection, and I set out the broad timescale for that in my statement.
After the population-wide testing programme ceases in its current form, testing will be used to ensure that people who would benefit from, and are eligible for, antiviral treatment get speedy access to it. The treatment is being offered on a fairly restricted basis, but it will expand as more antiviral treatments become available.
We will continue to ensure that we communicate with particular groups about on-going provision of testing. Some of the detail of that provision has already been set out in “Coronavirus (COVID-19)—testing strategy: update—March 2021”, which I think was published two weeks ago.
With regard to schools, we will continue to develop the guidance. It is not testing that is causing young people to be absent, but high levels of infection, so it is important that we get infection levels down so that we reduce the impact of the virus on schools, just as we want to reduce it in broader society.
As we have done all along, we continue to take a balanced approach to the measures that are in place in schools. We will continue to ensure targeted access to testing on the basis that is set out in the testing strategy, and we will go beyond that as far as we can if necessary, given the constraints on funding that I have set out previously in the chamber.
I, too, share Jackie Baillie’s concerns about the paucity of detail on removal of universal access to free LFTs. A fortnight ago, I wrote to the First Minister about the cost of LFTs after 1 May. The Scottish Government has moved in lock step with the UK Government on testing, which means an end to free lateral flow tests in almost all circumstances. They are already being sold online.
Thousands of people rely on LFTs to protect their loved ones, to protect people whom they know are immunosuppressed and to protect those who have spent months shielding from Covid. Understandably, they want to give those people comfort and confidence, but they will be worried about the new cost of caring. It is nothing short of a “Visit your gran” tax.
Will the First Minister guarantee that all carers, NHS staff, and care home staff and visitors have access to free Covid tests? Will she commit to creating a scheme to ensure that free LFTs are available for those who are anxious to protect vulnerable loved ones?
The Scottish Government is not in the same position on testing as the UK Government. A cursory look at the position of the UK Government will testify to that. We still support testing in ways that are currently not being used in the rest of the UK. We will continue to support appropriate and targeted use of testing for the purposes that are set out in the testing strategy, and when we advise people to take tests, we will not expect them to pay for those tests, but will continue to ensure access to testing free of charge.
Of course, we will continue to have discussions with people who care for others and people who visit loved ones in particular settings in order that we ensure that there is appropriate access to testing as we move beyond the population-wide approach that we have taken until now.
Given the relentless pressure on NHS Lanarkshire acute care, with local hospitals currently operating beyond 100 per cent capacity, what more can the Scottish Government do to ensure that the public is aware of the right place to access non-critical care services, and that such provision is available?
We continue to work with the health service in a range of ways to support it through an exceptionally challenging period. We are also taking steps to ensure that the public is aware of the right place to access non-critical care and what provision is available. A number of public awareness campaigns have been run, including the general practice access campaign, the right care right place campaign, the NHS 24 winter campaign, and the receptionist campaign, which aired on television and radio in March and focused on the role of the receptionist as a navigator of care. As part of our broader efforts to reform how people access care in a way that is better for them, we will continue to ensure that information is available while the NHS continues to navigate through this incredibly difficult period.
I recently saw a woman in her 20s who later died from ovarian cancer because she was too worried to present with symptoms because of GPs being overwhelmed. We know that none of the health boards has made the 62-day standard for treating suspected cancer patients. Macmillan Cancer Support has said that the cancer care system was struggling before the pandemic and it is now failing to cope, despite the herculean efforts of NHS staff. What is the Government doing now—I stress the word “now”—to help to save the lives of those who are facing delays for cancer treatment, as we know that early diagnosis and timely treatment lead to better outcomes and that the money that the First Minister has already announced has not solved the problem?
Cancer care was rightly a priority throughout the pandemic, and it continues to be so. The 31-day cancer treatment target has been met consistently, and there is a real focus on ensuring that the 62-day target is met. Of course, median waiting times for access to treatment are very short, but we recognise the importance of doing more about early detection of cancer, which is why the detect cancer early campaign has the investment and support that it does. The new early diagnostic centres that I have spoken about previously are also being developed.
This is a really important area of care and I end my answer with a very strong message to anybody who has symptoms that are indicative of cancer, or anybody who has symptoms causing them concern that they might have cancer, to seek medical attention urgently and contact their GP. Cancer is and will continue to be a clinical priority in the national health service.
I have to confess that the 2,300 people in hospital concerns me quite a lot, and it concerns quite a lot of other people. Is the First Minister confident that that number will reduce without us having further restrictions in place?
The number of people in hospital is obviously a concern to me, to the Cabinet Secretary for Health and Social Care and to the Government, which is why it is important that we continue to exercise a degree of caution.
We know from the journey of any infection and from our experience of Covid that, as we start to see case numbers come down, as I hope that we are beginning to do with the latest wave of infection, we will start to see the pressure on hospitals easing as well. We are keen that that happens as quickly as possible. We have an early indication in the hospital admission figures that we are starting to see a slight easing of pressure, but we want that to intensify in the days and weeks to come.
Of course, vaccination is providing significant protection against serious illness. Although the hospital numbers that we are seeing right now are putting severe pressure on the health service, those numbers would be much higher, but for vaccination. Because of vaccination, the number of people who need treatment in intensive care is lower than it has been at previous stages of the pandemic.
I am not complacent, nor should any of us be complacent, about the pressure on our national health service, but we know that, if case numbers fall—if the current wave has peaked, the fall in case numbers will become more pronounced in the days ahead—the pressure on our NHS will start to ease some days after that.
Our hospitals are under immense pressure, and A and E waiting times are shocking. Care at home and residential care services are also under immense pressure, and schools in some parts of the country are having to temporarily close. Already high staffing shortages are being exacerbated by Covid-related absences. As a consequence, people who need support are often falling through the gaps and staff are struggling to keep things going. I am talking about older people who need care and young people who are preparing for exams.
What urgent additional support will the First Minister provide to support services that are in desperate need? Will she clarify the Government’s plans for self-isolation and testing as we move forward into the spring and summer period?
The Cabinet Secretary for Education and Skills has previously set out the support that is available for young people who are studying for exams. We continue to engage with the Convention of Scottish Local Authorities on the support that local authorities are providing for social care services.
The future approach to testing and self-isolation has been set out in the testing strategy. We will continue to advise people who test positive and who have symptoms of Covid to isolate. That is the responsible thing for all of us to do.
Even despite the protection that vaccination gives us against serious illness, one of the biggest challenges of case rates being as high as they are now is the level of staff absences across key critical services that is caused. The way to ease that is to get case numbers down. That is why we continue to take the cautious approach that we are taking, and why we are optimistic that we are starting to see the corner being turned, such that that pressure, along with the other pressures on the NHS, will ease in the days ahead.
A rapid review by the UK Health Security Agency suggests that people who are vaccinated are less likely to develop long Covid, even if they catch the virus. Would the First Minister therefore encourage anyone who has not yet had the vaccine to come forward and do so?
Yes, I would very strongly give that encouragement. The study referred to underlines the benefits of receiving a full course of Covid vaccination. That is the best way of protecting ourselves from serious symptoms when we get infected, and it might also help to reduce any longer-term impact.
We know that vaccination has been the most effective tool that we have had against the virus, and that will continue to be the case. I say to anyone who has not yet come forward for their first, second or third dose that it is not too late; please make sure that you contact the helpline or get in touch with your doctor in order to be vaccinated as quickly as possible. It is not too late to be vaccinated, so please do not feel embarrassed about coming forward now—you could be giving yourself and your loved ones vital protection.
For some people, face coverings are an inconvenience but, for others, they make the difference between being able to go about their lives safely and contracting a serious illness. Face coverings reduce risk, and they provide an extra layer of protection to people who are vulnerable to the virus, many of whom will be concerned about the decision to convert the legal requirement into guidance.
Has the Scottish Government consulted disabled people’s organisations about the impact that that decision will have on people who are clinically vulnerable?
We will continue to engage with a range of groups in the population about all of those decisions. It is the case that, as I have laid out in the chamber many times before, with any legal restriction, we have to be sure that we act lawfully. That means that we must make an assessment of the proportionality of keeping any measure in law. That applies to the face covering measure as it did previously to all others. We have to balance those decisions carefully.
Gillian Mackay is right about the broad balance of public opinion on face coverings. I have to say that I get many more contacts from people who are worried about the requirement to wear a face covering no longer being in law than I do from people who are annoyed about having to wear face coverings. I accept that nobody wants to have to do anything like that if it is not necessary but, if wearing a face covering helps to provide some protection to others, particularly those who are most clinically vulnerable to the virus, then I think that, particularly after all the sacrifice and heartache of the past couple of years, the vast majority of people accept being asked to do that for a couple more weeks whether or not they like it.
These decisions have to be taken carefully and we will seek to do that as far as we possibly can.
Following on much the same strain, does the First Minister agree that Douglas Ross should remember that we wear face coverings not just for ourselves but mainly to protect the stranger next to us on the bus or in the supermarket who might be, for example, undergoing cancer treatment and be immunodeficient without us knowing and who needs us to wear our masks so that they can at least go out and shop?
Before the First Minister responds, I point out that members are encouraged to ask questions on issues raised by the First Minister in her statement.
First Minister, be very brief because we are very tight for time.
We should possibly all remember—despite the wall of abuse that came from the Conservative section of the chamber during that question—that, although we might have disagreements, we are dealing with a pandemic of an infectious virus and perhaps we can try to deal with the issues in a more civilised way than some members in the chamber are demonstrating.
Christine Grahame is right. The wearing of a face covering is about giving other people protection. When we are in a supermarket, we do not know who might be close by who is more clinically vulnerable to the virus. While infection levels are as high as they are right now—we hope that they will reduce in the days and weeks to come—if wearing a face covering in a supermarket, for example, might reduce the risk of passing the virus to somebody who, if they got it, would become, or be at risk of becoming, seriously unwell, that is a price that most of us are willing to pay at this stage of the pandemic.
Given everything that the First Minister just said, why did she not wear a face mask yesterday?
I abided by the rules in place there. I wore a face covering on the train to and back from London. I abide by the rules. I know that the Conservatives perhaps struggle to understand it, but I abide by the rules.
News reports suggest that the Metropolitan Police are about to issue fines—[Interruption.]
I would be very grateful if we could hear Ms Mackay, thank you.
Thank you, Presiding Officer.
News reports suggest that the Met Police are about to issue fines to at least 20 officials who breached Covid restrictions by attending parties held at Downing Street. Is the First Minister concerned that those events in Westminster potentially undermine public health messaging in Scotland?
I appreciate that the issue touches on Covid. It might be the member’s view that that is the case. However, this question session is for questions to do with the issues that were raised in the First Minister’s statement.
First Minister, be very brief.
I believe that it is important to continue to take balanced judgments. I hope that we are getting to a point at which the pandemic is behind us but, right now, while levels of infection are as high as they are, my job—my duty—is to take decisions that are right for the people of Scotland. That is what I will continue to do. No doubt that will meet a wall of criticism, whatever I do, from the Conservative members. However, my job—my duty—is to do right by the people of Scotland, and that is what I will always seek to do.
That concludes the First Minister’s statement on the Covid-19 update.
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